How low should we target the LDL goal to improve survival for acute coronary syndrome patients in Hong KongReport as inadecuate




How low should we target the LDL goal to improve survival for acute coronary syndrome patients in Hong Kong - Download this document for free, or read online. Document in PDF available to download.

BMC Cardiovascular Disorders

, 15:117

First Online: 07 October 2015Received: 04 March 2015Accepted: 30 September 2015DOI: 10.1186-s12872-015-0117-y

Cite this article as: Lee, V.W., Chau, R.Y., Cheung, H.Y. et al. BMC Cardiovasc Disord 2015 15: 117. doi:10.1186-s12872-015-0117-y

Abstract

BackgroundUtilization of lipid-lowering agents has been associated with improved long-term outcomes in acute coronary syndrome ACS patients. However, updated data regarding local use and outcomes was lacking.

MethodsWe retrospectively reviewed 696 hospitalized patients in the local ACS registry of Prince of Wales Hospital during 1 January 2008 to 31 December 2009 with data retrieved using computerized clinical records of all patients.

ResultsAmong the 402 MI patients included, 104 25.9 % were not prescribed with statins at discharge. Percutaneous coronary intervention PCI not performed or planned during hospitalization OR: 0.324, p = 0.001 and latest lower LDL-C level before discharge OR: 0.221 for an increment of 1 mmol-L, p = 0.009 were significant independent predictors of the absence of statin prescriptions at discharge. A significantly lower all-cause mortality rate 14.4 % vs 51.7 %, p < 0.001, fewer total hospitalizations p < 0.001 and fewer hospitalizations due to cardiovascular problems p < 0.001 were observed in patients discharged with statins. LDL-C goal attainment of < 2.6 mmol-L resulted in a significant reduction in mortality 10.8 % vs 24.2 %, p = 0.001, but not for goal attainment of < 1.8 mmol-L. Significant difference in survival existed only when LDL-C cut-off values were above 2.4 mmol-L.

ConclusionsThis study revealed the under-utilization of statin therapy in eligible MI patients at discharge and unsatisfactory percentages of LDL-C goal attainment, and also reassured the role of low LDL-C reduction to < 2.6 mmol-L in the management of MI. However, the current study did not show that the lower LDL-C reduction improved survival of ACS patients. Further research should be conducted to assess the necessity of aggressive LDL-C reduction to < 1.8 mmol-L in local patients.

KeywordLipid-lowering Myocardial Infarction Hong Kong Clinical impact Statin Lipid Management  Download fulltext PDF



Author: Vivian W. Lee - Raymond Y. Chau - Herich Y. Cheung - Cheuk Man Yu - Yat Yin Lam - Bryan P. Yan

Source: https://link.springer.com/



DOWNLOAD PDF




Related documents